Economic burden of diabetes mellitus and its socio-economic impact on household expenditure in an urban slum area

Sophia D. Fernandes, Sunny D. A. Fernandes


Background: India is on the brink of an epidemic of diabetes mellitus (DM). In the near future, DM will pose a severe burden on the already fragile and under-resourced health care system in India.

Methods: A prospective community based cohort study was taken up for assessing the financial burden on households of patients with DM in an urban slum of Mumbai to reflect the economic implications of DM.

Results: The mean age of participants was 51 years. Forty (33.33%) out of 120 were suffering from diabetes for more than 5 years and it was proved statistically that the total cost of expenditure on treatment per month was significantly related to the duration of DM. On an average the monthly direct expenditure was INR 687.5 per patient and indirect expenditure was INR 348.75 per patient. Catastrophic expenditure was borne by 5.8% of the participants.

Conclusions: Direct cost forms the major component of the total cost of DM management. The expenditure on the management of Diabetes increases with the duration of the illness. As the out-of-pocket expenditure is the mainstay of financing the cost of diabetes mellitus in India, there is a possibility of these households of DM patients might be pushed into the poverty trap. It is recommended that the Government facilities for management of DM should be strengthened and quality of services should be improved in the interest of diabetic patients. Public awareness campaigns about the economic implications of DM and services provided by the government should be carried out.


Catastrophic expenditure, DM, Healthcare expenditure

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